Basic Information
| Provider Information | |||||||||
| NPI: | 1326410689 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORRIERE | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | THERESA | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3714 INGERSOLL AVE | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503123411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153096011 | ||||||||
| FaxNumber: | 5153093014 | ||||||||
| Practice Location | |||||||||
| Address1: | 3714 INGERSOLL AVE | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 50312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153096011 | ||||||||
| FaxNumber: | 5153093014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2015 | ||||||||
| LastUpdateDate: | 08/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | B151052 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.